Aims To assess the relationship between vision impairment (VI) and major eye diseases, with vision-specific emotional well-being in a Chinese population.

Methods In this population-based cross-sectional study, 3353 Chinese participants aged 40–80 years answered the emotional well-being scale of the Impact of Vision Impairment questionnaire, validated using Rasch analysis. Participants underwent visual acuity testing and collection of sociodemographic and medical data from standardised questionnaires. The relationships between presenting bilateral VI, presence of major eye diseases (cataract, undercorrected refractive error, glaucoma, age-related macular degeneration and diabetic retinopathy) and emotional well-being were assessed using linear regression models. Stratified analyses for age, gender, education and immigration status were conducted to determine if change in β coefficients differed within each stratum.

Results Approximately half of patients (n=1805) had normal vision, and 43% (n=1534) and 3.4% (n=114) had moderate and severe bilateral VI, respectively. Vision-specific emotional well-being systematically worsened as severity of bilateral VI increased (p<0.001). Compared with no VI and no eye diseases, respectively, severe bilateral VI (23%; β −1.84; 95% CI −2.23 to −1.43) and glaucoma (β −1.88; 95% CI −3.00 to −0.76) were associated with a clinically meaningful reduction in emotional well-being. The reduction in vision-related emotional well-being was substantially and significantly greater in men compared with women (p<0.05).

Conclusions Severe VI and glaucoma are associated with substantial decrements in vision-specific emotional well-being, highlighting the importance of preventing progression of vision loss. Evidence-based interventions to improve vision-related coping skills and emotional management for patients with severe VI and glaucoma are warranted.